Asthma is a chronic or recurring, disabling illness, which offers a paradigm for the study of adjustment to chronic, disabling illness in general. Despite recent advances in the medical treatment of asthma, a large number of patients respond poorly even to intensive long-term treatment. The techniques, or coping styles, employed by poor responders seem to differentiate them from other patients for whom medical treatment is more successful. The proposed research focuses on two extreme coping styles, labeled High and Low Panic-Fear, both centering on how the patient presents himself to the physician and the manner in which he registers his distress. High Panic-Fear patients are characterized by anxiety (either focused on the asthma or diffuse), helplessness, depression, dependency, and symptom emphasis. Low Panic-Fear patients are characterized by exaggerated independence, an inability to share personal distress, and symptomminimization. Recent evidence suggests that the poor treatment response of High and Low Panic-Fear patients may be contigent upon unusual patterns of medication usage--either frequent requests for supplemental as-needed medications and treatments (over-utilization) by High Panic-Fear patients, or poor adherence to routinely scheduled medications and treatments (under-utilization) by Low Panic-Fear patients. The objectives of this proposal are: (A) To identify patterns of medication usage which occur among asthmatic inpatients, (B) To determine if these patterns show identifiable and significant linkages to the perpetuation of the illness or prolongation of hospitalization, (C) To evaluate the relationship between Panic-Fear and patterns of medication usage, and (D) On the basis of data obtained, to propose remediation plans, which can be tested clinically, for altering either the Panic-Fear response or the behaviors which stem from it, and thereby reduce the intractability of the illness and duration of hospital stay.